Acute Cholecystitis

Champion, Howard R.; Panebianco, Nova L.; Waele, Jan J. De; Kaplan, Lewis J.; Malbrain, Manu L. N. G.; Slaughter, Annie L.; Biffl, Walter L.; Moore, Ernest E.; Bhuva, Parita; Nathan, Barnett R.; Silverman, Michael E.; Shih, Richard D.; Gattinoni, Luciano; Carlesso, E.; Caironi, Pietro; Michalopoulos, Argyris; Falagas, Matthew E.; Mills, Angela M.; Dean, Anthony J.; Wyatt, Christopher R.; Moore, Ernest E.; Burlew, Clay Cothren; Miller, Chadwick D.; Soto‐Ruiz, Karina M.; Varon, Joseph; Peacock, W. Frank; Devarajan, Prasad; Jeyabalan, Arun; Badia, Joan R.; Lorente, José A.; Nin, Nicolás; Daher, Ramsey J.; Okusa, Mark D.; Moreno, Rui P.; Annane, Djillali; Farmer, Brenna M.; Ronco, Claudio; Ricci, Zaccaria; Ali, Jameel; Branson, Richard D.; Robinson, Bryce R. H.; Wijayasiri, Lara; Rhodes, Andrew; Cecconi, Maurizio; Reynolds, Stuart F.; Brindley, Peter G.; Brophy, Patrick D.; Baack, Michelle; Kellum, John A.; Srisawat, Nattachai; Hoste, Eric A. J.; Dickinson, Edward T.; Colonna, Alexander L.; Meredith, J. Wayne; El-Solh, Ali; Rowe, Brian H.; Corwin, Howard L.; Bartfield, Joel M.; Scalea, Thomas M.; AbdelFattah, Kareem R.; Minei, Joseph P.; Murray, Patrick; Hicks, Caitlin W.; Eichacker, Peter Q.; Uddin, S.; Lynch, Joseph P.; Pont, Anne-Cornélie J. M.; Barrett, Tyler W.; Bechtel, Brett F.; Gaieski, David F.; Goyal, Munish; Berger, Mette M.; Liaudet, Lucas; Vranckx, Pascal; Valgimigli, Marco; Serruys, P. W.; Loftus, Ian; Pyati, Srini; Brudney, Charles S.; Ochoa, Juan B.; Miranowski, Mary K.; Dodson, Rebecca M.; Kavalukas, Sandra L.; Barbul, Adrian; Egan, Jonathan R.; Festa, Marino S.; Haddad, Samir H.; Arabi, Yaseen M.; Collins, David W.; Shehabi, Yahya; Carsons, Steven E.; Meersseman, Wouter; Resnick, Daniel K.; Agrawal, Basheal M.; Thielen, Griet; Price, Susanna

doi:10.1007/978-3-642-00418-6_1053

Cited by 5 publications

(6 citation statements)

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“…Contrariwise, these results find validation and confirm in a Cochrane review and other recent observational studies. These studies highlighted, indeed, that early LC (within 48 h) during AC is related to lower surgical complications and lower incidence of BDI, also reducing operative time in comparison to an antibiotic-first approach followed by elective or deferred surgery [ 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

The critical view of safety during laparoscopic cholecystectomy: Strasberg Yes or No? An Italian Multicentre study

et al. 2020

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Background Laparoscopic cholecystectomy is considered the gold standard for the treatment of gallbladder lithiasis; nevertheless, the incidence of bile duct injuries (BDI) is still high (0.3-0.8%) compared to open cholecystectomy (0.2%). In 1995, Strasberg introduced the "Critical View of Safety" (CVS) to reduce the risk of BDI. Despite its widespread use, the scientific evidence supporting this technique to prevent BDI is controversial. Methods Between March 2017 and March 2019, the data of patients submitted to laparoscopic cholecystectomy in 30 Italian surgical departments were collected on a national database. A survey was submitted to all members of Italian Digestive Pathology Society to obtain data on the preoperative workup, the surgical and postoperative management of patients and to judge, at the end of the procedure, if the isolation of the elements was performed according to the CVS. In the case of a declared critical view, iconographic documentation was obtained, finally reviewed by an external auditor. Results Data from 604 patients were analysed. The study population was divided into two groups according to the evidence (Group A; n = 11) or absence (Group B; N = 593) of BDI and perioperative bleeding. The non-use of CVS was found in 54.6% of procedures in the Group A, and 25.8% in the Group B, and evaluating the operator-related variables the execution of CVS was associated with a significantly lower incidence of BDI and intraoperative bleeding. Conclusions The CVS confirmed to be the safest technique to recognize the elements of the Calot triangle and, if correctly performed, it significantly impacted on preventing intraoperative complications. Additional educational programs on the correct application of CVS in clinical practice would be desirable to avoid extreme conditions that may require additional procedures. Keywords Cholecystectomy • Critical view of safety • Laparoscopy • Bile duct injuries • Intraoperative bleeding • Laparoscopic training Laparoscopic cholecystectomy (LC) is currently and worldwide considered the gold standard for the treatment of gallbladder lithiasis. Since its introduction, in the early 1990s, this procedure has gained a remarkable consensus until becoming a routine surgical procedure. LC is characterized by a reduction in postoperative pain, hospital stay, and recovery times to normal daily activities, which translates into reduced costs for the national healthcare systems (NHS) [1]. However, this procedure comes with an increased incidence of bile duct injuries (BDI), compared to open cholecystectomy (OC): 0.3% and 0.8% vs 0.2% [2-7]. LC-related BDIs include minor injuries up to complex hilar injuries, as classified by Strasberg et al., in which the and Other Interventional Techniques

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Section: Discussionmentioning

confidence: 99%

The critical view of safety during laparoscopic cholecystectomy: Strasberg Yes or No? An Italian Multicentre study

et al. 2020

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“…4,5,13 Our data did, however, show a rise in emergent admissions, which could be attributed to the specific rise of acute cholecystitis. 2,20 Multiregional analysis is warranted to better characterize these trends. One possible explanation for this fall in total cholecystectomy procedures is the shifting indications for elective laparoscopic procedures and more thoughtful decision-making by both surgeons and patients, who are better informed about the substantial risks of surgery.…”

Section: Resultsmentioning

confidence: 99%

“…1 Epidemiologists have gone to great lengths to identify and characterize factors contributing to the high prevalence of gallbladder disease in the United States. [2][3][4][5] Variables such as race, gender, and socio-economic class all contribute to the manifestation of this disease. 4,5 While data on reductions in mortality or morbidity have been conflicting, laparoscopy has been shown to reduce patient hospital stays and total costs.…”

Section: Introductionmentioning

confidence: 99%

Trends and Factors Impacting Healthcare Charges and Length of Stay for Cholecystectomies: A New York State Population-based Analysis

Darbandi¹,

Chopra²

2021

Int J Med Students

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Background: Gallbladder disease confers a significant economic toll on the United States healthcare system. This study aims to characterize current trends and features of the cholecystectomy population and identify factors that influence the length of stay and total charges. Methods: Case information was extracted for laparoscopic and open cholecystectomies from 2013-2016 using the New York Statewide Planning and Research Cooperative System (SPARCS) database. Descriptive, comparative, and multivariable linear regression analysis was conducted on 58,141 cases assessing age group, race, gender, admission presentation, surgical technique, insurance status, year of operation and severity of illness by the length of stay and total charges. Results: Of all procedures, 91.6% were laparoscopic, and 79.4% were emergent on admission. Total procedures trended down, while laparoscopic and emergent cases steadily increased (p<0.0001). Total charges increased during the study period, while the length of stay decreased (p<0.0001). Open and emergent procedures were associated with a higher cost and longer inpatient stays (p<0.0001). Open procedures were proportionally more common among elderly, male patients, and elective cases (p<0.0001). Emergent presentation was more common in females, non-whites, and younger patients (p<0.0001). Regression model showed that male gender, open operation, Black race, and emergent presentation were independent predictors for a longer stay and greater total charges (p<0.0001). Medicare insurance predicted lower total charges but longer length of stay (p<0.0001). Conclusion: Race, insurance, procedure type, and patient presentation influence hospital charges and stays following cholecystectomy. Understanding these trends will allow policymakers and providers to limit the healthcare burden of cholecystectomy.

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“…Данас се све више примењује лапароскопска интервенција уместо конвенционалног хируршког приступа а у оба случаја, операција може да буде рана или касна. Док једни препоручују рану холецистектомију, унутар 7 дана, као најоптималније лечење други саветују прво смирење симптома а операцију после неколико дана или накнадно (5,37,38). Без обзира на то ако лекар утврди да постоје разлози за хоспитализацију треба да упути болесника на болничко лечење што пре, по правилу унутар 24 сата.…”

Section: какво је хируршко лечење ?unclassified